GI: Treatment of GI Infections

Question 1

Treatments for C. Diff

Answer 1

Vancomycin (oral glycopeptide)

Findaxamicin (macrolide)

Question 2

Treatment for C. jejuni, Salmonella, and Shigella

Answer 2

Ciprofloxacin
Azithromycin
+ others!

Question 3

What are the two options for treating helminths?

Answer 3

Benzimidazoles
-albendazole, mebendazole, thiabendazole

Misc.

• ivermectin
• nitazoxanide
• praziquantel
• pyrantel pamoate

Question 4

MOA for the Benzimidazoles?

Answer 4

1. Inhibit microtubule polymerization via B-tubulin binding
   - -reduces glucose transport
2. Inhibit Mito fumarate reductase
   - resulting in immobilization and death

Question 5

Ivermectin MOA

Answer 5

Inhibits glutamate gated Cl- channels

-induces hyperpolarization to paralyze worms

Question 6

MOA of Nitazoxanide

Answer 6

interferes with pyruvate:ferredoxin oxidoreductase (PFOR) enzyme depenedent electron transfer that is essential to anaerobic energy metabolism

Question 7

MOA of praziquantel

Answer 7

Increases cell permeability=loss of Ca leading massive contractions and paralysis

Question 8

Pyrantel pamoate MOA

Answer 8

Depolarizing NM blocker

• opens non-selective cation channels and activates nicotinic ach receptors
• -massive Ach release=spastic paralysis of parasites

Question 9

What are the two anti-protozoals?

Answer 9

Paromomycin

Metronidazole and Tinidazole

Question 10

Paramomycin MOA

Answer 10

Unknown, maybe works to inhibit 30s

Question 11

MOA for metronidazole

Answer 11

pro-drug; activated by electron transfer that creates nitro-free radicals as electron sink to destroy DNA

Question 12

How would you treat amebiasis?

Answer 12

metronidazole followed by paromomycin

Question 13

how would you treat anclostoma/necator americanus? (hookworms that cause IDA)

Answer 13

Albendazole

Question 14

How would you treat ascaris lumbricoides (roundworm)?

Answer 14

Albendazole

Question 15

How would you treat giardia?

Answer 15

Metronidazole (tinidazole)

Question 16

How would you treat adult tapeworms? (diphyllobothrium or taenia)

Answer 16

Praziquantel

Question 17

How would you treat echinococcus?

Answer 17

Albendazole + praziquantel

Question 18

How would you treat taenia solium caused cysticercosis?

Answer 18

Albendazole

Question 19

How would you treat pinworms (enterobius vermicularis)?

Answer 19

Mebendazole (albendazole)

Question 20

How would you treat schistosoma?

Answer 20

Praziquantel + steroids for neuro issues

Question 21

How would you treat threadworm strongyloides stercolis?

Answer 21

ivermectin

Question 22

How would you treat the whipworm trichuris trichirua?

Answer 22

Mebendazole (Albendazole)

Question 23

How would you treat Trichinellosis?

Answer 23

Albendazole + Steroids (for severe)

Question 24

How would you treat cryptosporidium?

Answer 24

Nitazoxanide

Question 25

How would you treat cyclospora cayetanesis

Answer 25

TMP-SMX (non allergies) Ciprofloxin for sulfa allergies

Question 26

How would you treat Plamodium Falciparum?

Answer 26

Atovaquone or Proguanil

Question 27

MOA for atovaquone

Answer 27

interferes with Mito electron transport and ATP synthesis

Question 28

MOA for proguanil

Answer 28

selectively inhibits bifunctional DHF reductase thymidylate synthase enzyme -results in inhibition of DNA synthesis since no folate cofactors